Although considerable epidemiologic evidence exists which supports an association between psychosocial factors and ischemic heart disease (IHD), little is known concerning the pathophysiologic pathways which account for these associations. This will be the first population-based, prospective epidemiologic study to examine the relationship between psychosocial factors and carotid atherosclerosis, ischemia and arrhythmias on exercise and ambulation, and thrombotic factors. Thus it will be able to isolate the role of a number of the major pathophysiological pathways in the association between psychosocial factors and IHD. The prospective design will permit an examination of the association between psychosocial factors and the prevalence and progression of carotid atherosclerosis, prevalence and incidence of ischemia and arrhythmias, degree and progression of clotting tendency, and incidence of IHD. The results of these analyses will help to clarify the role of social support and social network participation, anger and hostility, Type A behavior, job strain, socioeconomic status, coping, depression, and other factors in the development of IHD. Significantly this will be accomplished in a 4-year follow-up of 3,166 men, aged 42-60, who were studied as part of the Kuopio Ischemic Heart Disease Risk Factor Study in Eastern Finland. The availability of substantial amounts of data already collected, state-of-the-art measurement of physiological and psychosocial variables, and a comprehensive set of risk factors and outcomes, makes this an unique opportunity to add to our understanding of the relationships between psychosocial factors and IHD.